NIZAR MOHAMMAD KHERALLAH MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036140748

License Status

INACTIVE

Business

Title

First Name

NIZAR

Middle

MOHAMMAD

Last Name

KHERALLAH

Business Name

NIZAR MOHAMMAD KHERALLAH MD

Original Issue Date

05/23/2016

Effective Date

05/08/2017

Expiration Date

09/30/2020

City

EDWARDS

State

Zip

61528

County

PEORIA

Ever Disciplined

LastModifiedDate

04/05/2020